Royal Osteoporosis Society - Reading Osteoporosis Practice- The "Steady" Pillar – Preventing Falls

You might be eager to start lifting weights or jogging to build your bone density (the “Strong” pillar), but if your balance is poor, those activities could actually put you at risk of a fall. The sources explain that for those who are frail or unsteady, we must build a dependable foundation first.

Think of it like designing a building in an earthquake zone. It isn’t the strongest or most rigid buildings that survive, but those with foundations and structures designed to absorb, adapt and respond to movement. By developing your balance, adaptability and reaction time, you’re building the same kind of resilient foundation for your body.

How to Become “Steady”

The “Steady” pillar is all about training your brain and your muscles to work together to keep you upright, especially if you trip or lose your footing.

The guidelines recommend several specific types of exercises to improve your balance and gait (the way you walk)

Note: However, if you want to continue activities such as trail running or hiking on uneven ground, dog sports (Agility, Flyball, Hoopers), equestrian activities, tennis, padel, badminton, table tennis, walking football, and other hobbies which are activities that demand rapid balance reactions, agility, coordination and the ability to recover from unexpected perturbations. Consider an assessment with an advanced practice physiotherapist to review whether your balance and movement skills match the demands of the activities you enjoy.

ROS Recommendations:

• • Challenging Your Balance: This means doing movements that make you feel slightly “unsteady” so your body learns how to correct itself.
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  • Tandem Standing and Walking: This is like walking a tightrope. Place one foot directly in front of the other so the heel of your front foot touches the toes of your back foot 
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  • Single-Leg Stands: Practice standing on one leg while holding onto a sturdy chair or kitchen counter. As you get better, try just using one finger for support, and eventually, no hands at all.
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  • Reduced Base of Support: This simply means standing with your feet closer together than usual, which makes it harder to stay balanced.
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  • Uneven Surfaces: Once you are more confident, practicing these movements on a rug or a patch of grass can further challenge your balance.
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• Improving Your Gait (Walking Pattern):
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• • Heel-to-Toe Walking: Focusing on how your feet hit the ground.
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  • Toe and Heel Raises: Standing and lifting your heels, then lifting your toes. This strengthens the ankles, which are vital for “catching” yourself if you trip.
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• Specific Activities:
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• Tai Chi: This is highly recommended in the sources because it uses slow, controlled movements that are excellent for balance. However it doesn’t train rapid reaction time. agility and the ability to recover from unexpected perturbations.
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• Dance: Whether it’s ballroom or line dancing, moving in different directions helps your coordination. Note: Almost every form of dance whether with a partner, or solo has a differing level of balance and coordination demand.